[cesarean section and mother infant bond.. Is there a difference in the bond in those that had planned c section and those that had emergency c section]

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aCesarean Section

Background

Despite the historical constancy of a woman's likelihood to become pregnant at some point in her life, modern American women experience pregnancy quite differently than our great-grandmothers. Six trends mark the shifts of the last century: Pregnancy is safer than ever, women are delaying childbirth, teen pregnancy is declining, abortion rates are declining, women are increasingly bearing and raising children outside of marriage, and women are bearing fewer children. Access to nutritious food, clean living conditions, and overall healthier living have helped women experience safer and healthier pregnancies in the late 20th and early 21st centuries than in previous generations. Less than .01 percent of women die because of pregnancy or childbirth-related complications in the 21st-century United States, compared with about .07 percent in 1950 (Rothman, 2007).

The death rate increases as women age. Maternal mortality remains a significant problem worldwide. Twenty percent of pregnant women in the United States are without prenatal care in a given year (down from 30 percent in 1990). Ninety-nine percent of American women give birth in a hospital setting, but home births and freestanding birth clinics are regaining popularity as some women challenge the medicalization of pregnancy. In 2004, 29 percent of births took place by cesarean section.

Problem Statement

Most women wish to avoid cesarean section because it is not a risk-free procedure. External cephalic version is the only effective and basically safe intervention to convert a breech fetus to vertex presentation with the potential to help women avoid operations. It is performed exclusively through the abdominal wall by gentle pushing on the abdomen while viewing fetal movement with real-time ultrasound. The buttocks are elevated from the birth canal and grasped laterally, while the fetal head is directed toward the pelvis. Uterine relaxation, induced by certain drugs, is sometimes recommended before the procedure. Fetal heart rate monitoring is performed before and after the external version for assessment of fetal well-being (Hertz, 2006).

Significance of the Study

It is important to consider potential confounders and effect modifiers. For instance, the reason for the difference could be due to differences in age or comorbidities (i.e., differences in guideline-appropriate cesarean sections are due to underlying patient characteristics among women giving birth in the two regions). There are several methods to evaluate if 'other factors' are the reason for an association.

Literature Review

The risk for urgent cesarean delivery for fetal distress following external version is less than ...